Cardona-Arias Jaiberth Antonio, López-Carvajal Liliana, Tamayo Plata Mery Patricia, Vélez Iván Darío
School of Medicine, Cooperative University of Colombia, Medellín, Colombia.
School of Microbiology, University of Antioquia, Medellín, Colombia.
J Evid Based Med. 2017 May;10(2):81-90. doi: 10.1111/jebm.12245.
The treatment of cutaneous leishmaniasis is toxic, has contraindications, and a high cost. The objective of this study was to estimate the cost-effectiveness of thermotherapy versus pentavalent antimonials for the treatment of cutaneous leishmaniasis.
Effectiveness was the proportion of healing and safety with the adverse effects; these parameters were estimated from a controlled clinical trial and a meta-analysis. A standard costing was conducted. Average and incremental cost-effectiveness ratios were estimated. The uncertainty regarding effectiveness, safety, and costs was determined through sensitivity analyses.
The total costs were $66,807 with Glucantime and $14,079 with thermotherapy. The therapeutic effectiveness rates were 64.2% for thermotherapy and 85.1% for Glucantime. The average cost-effectiveness ratios ranged between $721 and $1275 for Glucantime and between $187 and $390 for thermotherapy. Based on the meta-analysis, thermotherapy may be a dominant strategy.
The excellent cost-effectiveness ratio of thermotherapy shows the relevance of its inclusion in guidelines for the treatment.
皮肤利什曼病的治疗具有毒性、存在禁忌证且成本高昂。本研究的目的是评估热疗法与五价锑剂治疗皮肤利什曼病的成本效益。
有效性是愈合比例和不良反应的安全性；这些参数通过一项对照临床试验和一项荟萃分析进行评估。进行了标准成本核算。估计了平均成本效益比和增量成本效益比。通过敏感性分析确定了有效性、安全性和成本方面的不确定性。
使用葡糖酸锑钠的总成本为66,807美元，热疗法的总成本为14,079美元。热疗法的治疗有效率为64.2%，葡糖酸锑钠的治疗有效率为85.1%。葡糖酸锑钠的平均成本效益比在721美元至1275美元之间，热疗法的平均成本效益比在187美元至390美元之间。基于荟萃分析，热疗法可能是一种优势策略。
热疗法出色的成本效益比表明将其纳入治疗指南具有重要意义。
